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Three resistant strains of<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. parapsilosis<\/jats:named-content>were obtained following prolonged<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">in vitro<\/jats:named-content>exposure of a susceptible clinical isolate to constant concentrations of fluconazole, voriconazole, or posaconazole. We found that after incubation with fluconazole or voriconazole, strains became resistant to both azoles but not to posaconazole, although susceptibility to this azole decreased, whereas the strain incubated with posaconazole displayed resistance to the three azoles. The resistant strains obtained after exposure to fluconazole and to voriconazole have increased expression of the transcription factor<jats:italic>MRR1<\/jats:italic>, the major facilitator transporter<jats:italic>MDR1<\/jats:italic>, and several reductases and oxidoreductases. Interestingly, and similarly to what has been described in<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. albicans<\/jats:named-content>, upregulation of<jats:italic>MRR1<\/jats:italic>and<jats:italic>MDR1<\/jats:italic>is correlated with point mutations in<jats:italic>MRR1<\/jats:italic>in the resistant strains. The resistant strain obtained after exposure to posaconazole shows upregulation of two transcription factors (<jats:italic>UPC2<\/jats:italic>and<jats:italic>NDT80<\/jats:italic>) and increased expression of 13 genes involved in ergosterol biosynthesis. This is the first study addressing global molecular mechanisms underlying azole resistance in<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. parapsilosis<\/jats:named-content>; the results suggest that similarly to<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. albicans<\/jats:named-content>, tolerance to azoles involves the activation of efflux pumps and\/or increased ergosterol synthesis.<\/jats:p>","DOI":"10.1128\/aac.01127-10","type":"journal-article","created":{"date-parts":[[2011,4,26]],"date-time":"2011-04-26T03:04:49Z","timestamp":1303787089000},"page":"3546-3556","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":76,"title":["Transcriptional Profiling of Azole-Resistant Candida parapsilosis Strains"],"prefix":"10.1128","volume":"55","author":[{"given":"A. 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